Undocumented Motherhood: Gender, Maternal Identity, and the Politics of Health Care

Stratified Access and Experiences of Maternal Health Care in the United States-Mexico Border Region

INTRODUCTION

The United States (US) state of Texas uses two publicly funded programs to cover pregnant people-Medicaid for Pregnant Women and Children's Health Insurance Program (CHIP) Perinatal. While Medicaid offers more comprehensive coverage than CHIP Perinatal, it only includes US citizens and legally qualified residents. This tiered access to care, determined primarily by immigration status, generates stratified access. This paper explores how stratified access factors into reproductive experiences.

METHODOLOGY

Thirty-two pregnant and postpartum women who identified as first- or second-generation immigrants and had public insurance or no insurance coverage participated in a semi-structured in-depth interview. Interview questions explored topics related to immigration and border policies more broadly. This piece analyzes themes that emerged in relation to the type of healthcare coverage participants were able to access during pregnancy.

RESULTS

Participants had a range of immigration statuses that factored into their eligibility for health programs. During pregnancy, 12 had CHIP Perinatal, 15 had Medicaid, and five had no coverage. Key themes shaping experiences of care included bureaucratic barriers in navigating health programs, inadequate coverage that reinforced health vulnerabilities, and feelings of limited autonomy.

DISCUSSION

Women's narratives highlight the ways immigration status generates barriers to receiving health care coverage, including coverage for programs that individuals are entitled to regardless of immigration status. The type of coverage that a pregnant woman has dictates how comprehensive her care is and the degree to which she experiences coverage gaps outside of pregnancy.

Latin American Youths' Migration Journeys and Settlement in the Tarapacá Region in Chile: Implications for Sexual and Reproductive Health

The sexual and reproductive health of young migrants has not been sufficiently addressed in mobility studies. In this article, we dwell on some aspects of this issue in the migration process of Latin American youth. We conducted a qualitative study in the region of Tarapacá, Chile, carrying out in-depth interviews with key informants, health staff and young migrants between 18 and 25 years old. The results show some motivations to migrate related to sexual and reproductive health: young pregnant women, LGBTQI+ and HIV-positive people seeking access to health care and social contexts of reduced gender discrimination. During the migration process, young people are exposed to various kinds of sexual violence, and in their settlement in Chile, to situations of racism, stigma and discrimination in society as a whole and in access to and during sexual and reproductive health care. Health care for young migrants is mainly focused on maternal care and reproductive issues, while sexual health as a whole is disregarded. We argue that sexual health must be addressed as a central dimension of the lived experiences of young migrants, and that the social, cultural and structural factors that undermine their sexual and reproductive health must be addressed in order to provide culturally competent health services.

COVID-19 and decreased asylum access: mother work, precarity and preocupación among Central American asylum-seekers in Los Angeles

In 2020, the public health response to the COVID-19 pandemic and the U.S. government's increased legal restrictions on asylum-seekers acted together to increase social, economic and legal precarity in the lives of Central American asylum-seeking mothers in Los Angeles. In this context, these asylum-seeking mothers discussed their intersectional precarities through the idiom of distress "preocupación", which signalled the concerns, worries, and fears they had in relation to the daily mother work of raising their children. Using ethnographic data collected during the COVID-19 pandemic, I examine how the intersectional precarities Central American asylum-seeking mothers faced necessitated protecting their children from their own preocupación. Through this, I argue that by using the analytic of preocupación it is possible to see exactly how racial and legal barriers to care increase precarity in the lives of asylum-seeking mothers in the U.S., and the detrimental impact that intersectional precarities have on asylum-seekers' mother work today.

Coming Out of Employers' Homes:Migration, Domestic Work and Health Claims

Migrant domestic workers in Kuwait live amid structural inequalities, including health disparities, yet little is known about how they manage wellness alongside imperatives to work and earn. In this article, I examine Sri Lankan women's coming out of employers' homes through authorized and unauthorized channels and how they use illness and exhaustion to justify their need for more autonomous conditions. Exploring the physical, emotional, and political dimensions of these processes, I highlight the Sri Lankan vernacular notion of "heart-being" within women's actions to safeguard health and seek existential grounding, as they assert biolegitimate claims to return home or live unauthorized.

Time Discipline and Health/Communicative Labor in Pediatric Primary Care

In rural Southern Chile, native Mapuche families receive care mostly from non-indigenous clinicians. Parents and doctors alike orient to the importance of timely medical care, but clinical and communication norms also result in misunderstandings and tension. Parents find it hard to communicate about structural obstacles, and valued practices of care in families may conflict with normative expectations for timely presentation. Parents' disclosures about the duration of their children's illnesses can expose them to clinical censure, which in turn reinforces pernicious negative stereotypes about this racialized and marginalized community.